HomeMy WebLinkAbout94-00159
21 - 94 - 159
Rec:)!
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'94 JII1121
AFPIDAVIT
AND NOW,
this
l~t~
.hL:""" day of
Clei,
Cum~;.
I, John
January,
1994,
; of
",.':i1s
II Q '77
,,, ....-
...:urt
,:)., PA
Jipson,
Administrator of the Estate of Nancy L. Jipson, do hereby swear
that I am the husband of Nancy :... Jlp~o". Ioly ~Iife died on August
21, 1992, without assets. The Estate of Nancy L. Jipson currently
has no assets, and the Estate is being raised on behalf of Nancy L.
Jipson for the purposes of litigation.
I, the Administrator, hereby request exemption from filing a
bond for the aforesaid reasons.
~~~
A. m.
Joh Jl son
Sworn to and subscribed
before me this ~ day of
January, 1994.
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37826/T13
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
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The petitioner(s) above-named swear(s) or affirm(s). that the ClUJ i.
statements in the foregoing petition are true and correct to the best CUITlL
of the knowledge and belief of petitioner(s) and.that as personal
representative{s) of the above decedent petitioner(s) will well and
truly administer the estate according to law. ~ . ~.' '.
Sworn to or affirmed apd subscribed J tf---.
~cfo..e me this ..:>~ da~.fr
.?'~~~^~
Peter N. Welle ~~i8Ie.' l
7)u.'" ,.. ":4 C\.- ~ C:.'-'-4=< -k, ~
Q;..~ <;:), CO.fY'o.... ~ ._ ~~
+1-:>50 u'ct-'-\€ _'Su-.l-j'-O'1C,-,~ Ci>U-J-<'
No. . 21 - 94 - 159
'. urt
:, PA
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Estate of
NANCY L, JIPSON
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW FEBRUARY 22, 19~, in consideration of the petition on
the reverse side hereof, satisfactor)' proof having been I!resented before me,
IT IS DECREED that JOHN M. ,JIPSON JR.
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to
JOHN M.JIPSON. JR.
NANCY L. JIPSON
in the estate of
,&rt
FEES
Letters of Administration ..... $ 18 ,00
~rt Certificates( ).......... $
. t' $ i.OO
uncIa Ion ................
BOND $ 15 00
AFFIDAVIT TOTAL _ $ ~ 00
Filed ...f.E.~..?-.~..)~.~4.. A.D. 1~1.00
-';!J,C!-H14a :r AIr/V r'TSkr/ 58803
AlTORNEV (Sup. c.. 1.0. No.) I .
'IS-03 IUfIf'2TH ~~ Sitc"'E'T
~6s.PJ..I[@DRESS/ ~'n/lO
n )C:>3f?, -- /" /1/
"HONE
Mailed letters and order to attorney on 2-22-94.
'..
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
BE IT REMEMBERED that I, Mary C. Lewis, Register of Wills of
Cumberland County, Pennsylvania, do hereby deputize and commissionate
the Surrogate Court of the State of New York for the County of
Onondaga, to take the affidavit and oath of John Jipson, as
administrator for the estate of Nancy L. Jipson, late of,
Newville, Cumberland County, Pennsylvania. deceased.
IN TESTIMONY WHEREOF. I have hereunto set my hand and
affixed my official seal this 24th day of January 1994.
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1/., ,)A!t..(~. (: f/rf.-<:1/
Mary . Lew~
Regi ter of Wills
Cumberland. County Courthouse
1 Courthouse Square
Carlisle; PA 17013-3387
Register of Wills Office
421 Montgomery Street'
Onondaga County Courthouse
Surrogate Court
Syracuse, New York 13202
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~ National Grange Mutual
~Insurance Company
^ Mo!IIr1 Slreer America compony
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KNOW ALL MEN BY THESE PRESENTS: That the National Grange Mutual Insurance Company. a New Hampshire corporation hav.
mg its principal office In lhe Cily 01 Keene. Stale of New Hampshire, pursuant 10 Article V, Sect,on 2 01 the By.Laws 01 said Com,
pany. to w'l:
"Section 2. The board of directors. the president. any vice presidenl, secretary, or the treasurer shall have the power and authority
10 appoint attorneys'In.fact and to authorize them to execute on behall of the company and affix the seal of Ihe company thereto.
bonds, recognIZances, contracts 01 Indemnily or wfltings obligatory in the nature of a bond, recognizance or condillonal under.
laking and to remove any such attorneys.in.fact at any time and revoke the power and authority given to them." Pursuant to
said by.law does hereby make. constitute and appo,nt II Huey A,E. Long "______________________________
POWER OF ATTORNEY
-g liS true and lawful Attorneys.,n.tacl. to make. execute. seal and deliver for and on its behalf. and as its act and deed. bonds.
~ undertakings recognizances, contracts of indemnify, or other wfltings obligatory in the nature of a bond subject to the following
~ limitation:
~ 1. No one bond to exceed Five Hundred Thousand Dottars ($$00,000.00), ~
~ and to bind the National Grange Mutual Insurance Company Ihereby as fully and to the same extent a~' ~nstruments
~ were signed by the duly authoflzed officers 01 the Naltonal Grange Mutual Insurance Company, and all th~~~ f said Attorney
~ are hbreby ratified and conflrrTled. ~~\S
~ This power of attorney IS signed and sealed by faCSimile under and by the authorily of the folloWil}g.!~~ on adopted by the Direc.
g tors 01 The National Grange Mutual Insurance Company at a meeting duly called and held "{t1liI\~; d day 01 December 1977.
TJ Voted: That the signature of any officer authoflzed by the By.Laws and the company ,~I 'til1l1 be affixed by lacsimile to any
.~ power 01 attorney or special power of attorney or certification of either given fO(d9~ecution of any bond. undertaking.
.;: recognizance or other written obligat.i on in the nature thereof; such signature ~^C\ ~a'I, when so used being hereby adopted
~ by the company as the original signature of such office and the original se~~1he compa'1Y, to be valid and binding upon
u the company with the sama force and effect as though mar,ually affixed~v<0' <;,'iI
1 ~ ~ ......." '" ,-" ..~,. """''' G~.. .0"" '"'""!&om"', "'lI ~ ...... ,,,''''.."_.
'-: il . null and void any previous Power of Attorney at any time previous~nlshed tO~h ~\!f'e1'aid individuals or agencies.
E.f IN WITNESS WHEREOF. The National Grange Mutual Insurance C~~'has causecw resents to be signed by its Vice Presi-
E " dent and its corporate seal to be hereto affixed this 22fld \0 day~~ ember. 1993 . THIS ~rlle.I;T.
~ :: MENT S. HALL CEASE AND TERMINATE AUTOMA TICALL Y ~,s,,~F DECEM~E ~'t, 1995 ,unless sooner revo~.dl1~"~lO~ ~
~ '" "u~}' ../..1 #~~~ v.{I ~l>
.~ ~ , ~~> ~M AL GRANGE MUTUAL INS ~ "'1(" "'~
~ .~. 0..~\.'-, ;(9/~. c.", v '" i'"
E;;; 0c~/ By: >>t., ~3 o\~
il E ;::';,;\ ,j\ jf
~ 'E THIS POWER IS INVALD IF RED DIAGONAl,. I_FliNT "NA,TlO... ~L GRANGE MUTUAL INSURANCE COM KE NE, NEW _)
:E 8 HAMPSHIRE" IS NOT SHOWN IN ITS.~IRETY. ~ (;j?)>' ~ * ..;~
:;: g State cI.New Hampshire J:0, \9.';-) S--2:) . ,~ 'I( \\.~' ~f'
o ~ County of Cheshire \\'> 0 \0 EE~t. '"\~\'
~ .f? On this 22nd~)jl SePte'1!~l:" 19 93, before lhe subscriber a Notary Public of the WtWn~~w
1! E Hampshire on and lorthe ~~,DTCheshire.. 9yl~~missioned and qualified. came Thomas M. Van Berkel of the National Grange .'
~ ~ Mutual Insurance Co.mpa~)ne personllllyJcl)Own to be the officer described herein, and who executed the preceding Instrument.
'. ~ -' and he aCknowledg~~e execution,lll ~eri\e;'llnd being by me fully Sworn. deposed and said that he is an officer of said Company
. g:;; aforesaid: I.hat the);j~j:altlxed 10 ~!P..!.lil:8dlng instrument is the corporate seal of said Company. and the said corpo,\.....al~d
2 E his signature .l!.s;o,1Il'er wera duly affiised and subscribed to the said instrument by the authority and direction of t~.,'~ Ql~~'""
g:. that Artlclt! lI,jlection 2 of lhe By.Laws of said Company is now in lorce.~",.,~......-..,..,~~. \
o ~ ~.~' . ...... ..., ~
~ g, IN WIT, .. WHEREOF. I have hareunto set my hand and affixed by ollicial seal at Keene. New Hampshir C;/;\ 0 T II Il r\ 1
~ ~ ~~u<!: 2nd day of September 19 93. ~ ; .._ ;.~ ~
00,. ""'~ ';"7lJ 't, r':
"!>'" "~U8L\"" :
:; '-: . . Notarypubfic ..... .... i
g ~ . My Commission Expires: May 12. ,,~'...........,.~,~~l
. ~:: I. Lyn E. Landry, Assistant Vice President of the National Grange Mutual Insurance Company. do hereby certify th~~"
3.8 foregoing is a true and correct copy of e Power of Attorney executed by said Company which is Slill in full force anil'_1.
>-E
:i : IN WITNESS WHEREOF, I have hereunto set my hantl and affixed the seal of said Company at Keene, Ne.. Hampshire thiS
,,; E l~~h _dayof~~. ..193A-.
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STATUS REPORT UNDER RULE 6.12
Decedent:~/.... .J.'? s cNLl .,.',123 "'1 ~
Name of
Date of Death: 8- ~(- tId- e .,
,'.\
IV~~ O?/- 9!j~ 10"9 1)/\
Will No. Admin. No,
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1.
State whether agministration of the estate 1s complete:
Yes No V
2. I f the answer is No, state when the personal
representative reasonably believes that the administration w1ll be
complete: ,4, ~ t(rlJ~UlSlP'l1J Or- 11 fltl:1),UlI... M'h.~Mn"e Ct'rc;.S_ o/tf(CH tflfS
JUSf ffi\4CfE\)1 ~v CVIALIl 'Be ye.<tes 7>~U C/tVeLU/)ft). 1"1/15 (s ~'-Y A~Q: r:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
b, The separate Orphans' Court No, (if any) for
the personal representative's account is:
c, Did the personal representative state an
account 1nformally to the partiesl.n interest? Yes No
d, Copies of receipts,
approvals of formal or informal accoun
Cerk of the Orphans' Court and may b
Date:
tQl/
(717) Dl3g-67fl
Tel. No.
\I (MAHlrmf/AM3)
Capacity: _____Personal Representative
Lcounselfor personal
representative
STATUS REPORT UNDER RULE 6.12
Name of Decedent:~ l.
Date of Death: e -..2..13OL
Il'D'M~, No. 02.1 - l33!J - 0 I s-9
JT 1>5 0)\)
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the follow1ng with respect to completion of
the administrat10n of the above-captioned estate:
1. State whether adrninistrat10n of the estate is complete:
Yes__ No V-
2. If the answer is No, state when the personal
representative ,~sonably ~b lieves t_~a,~. _~he adrnil)istration will be
complete :1\2- o::t;xl..- ~ti _ oj It. ~ /II.(~~(1.(fi<<, ~ ~ ~
~..eM l'l'\ 1. '1 r- . - I
3. If the answer to No. 1 is Yes, state the following:
a, Did the personal representative file a final
account with the Court? Yes No
b, The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account 1nformally to the parties in interest? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may attac ed 0 th s report. .
Date: 6){'*~.;lq~ b
.
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Signat.ur
!11,'e./Met.. .j, t1J~M ~
Name (Please type or pint)
!j5:63 N~F/tIMJr. c;r.
Address
( 111) ~38- {, 79 I
Te 1, No,
!-IIW($~U~(,., ~.
17/10 .
Capacity: Personal Representative
~counsel for personal
representative
(MAHlrmflAM3)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
c.-
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BUREAU OF INDIVIDUAL TAXES
INHERlTANCE TAX DIVISION
DEPT. 280601
HARRISIURC, Pi 1712a~a601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
1I'.1147n'"I"-'''
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-06-98
JIPSON
08-21-92
21 94-0159
CUMBERLAND
101
AlIOunt R..ittod
NANCY
JOHN JIPSON
C/O MICHAEL J NAVITSKY
4503 N FRONT ST
HBG PA 17110
L
MAKE CHECK PAYABLE AND REMIT PAYMENT TG.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEii:isl;7-EX-AFji-ropj'rj-iliiiicE-oji-YN'iiEiiiTANci-TAin-pjiRA'isENiil:r,--ALLOWANCi-iii-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF JIPSON NANCY L FILE NO. 21 94-0159 ACN 101 DATE 04-06-98
TAX RETURN WAS: ( XI ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, Reel E.tete (Schedule AI
2. Stock. ond Bond. (Schedule BI
5, Cl...ly Neld St.ck/Pertnerahlp Intere.t (Schedule CI
4. Mortgag../Not.. Receivable (Schedule D)
S. CaSh/Bank Deposits/Hlle. Personel Property (Schedule EJ
6, J.lntly owned Property (Schedule FI
7. Trllnlfers (Schedule C)
I. Tote1 A...t.
NOTEI
RECEIPT
NUIIIER
DISCOUNT It I
INTEREST/PEN PAID (-I
( I CHANGED
NOTE: To insure proper
creel! t to your ItCcount I
_It thil _r portion
.f thla f.... with y...r
taK p.)'Hnt.
nl
(21
(51
t41
(51
(61
(71
.00
.00
,00
.00
6 .184,55
.00
.00
(II
6.184,55
~.lA6 lit;
.00
,00
,00
.00
,00
.00
.00
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
I IF TOTAL DUE IS LESS TlWt n. NO PAI'IlENT IS REClUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MY IE DUE
A REFUND, SEE REVERSE SIDE OF TNIS fOllN fOR INSTRUCTIONS,I
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funer.l Expens../Ada. Ca,t,,"l.c. Expense. (SChedule H)
10, Dobt./Hortgage Llabllltle./Llan. (Schedule II
11, T.tal Daduotlon.
12, Net Velue .f TllX Return
15, Charltable/Go.emeantel Beoue.t'l Non-elected 9115 Tru.t. (SChedula JI
14. Net Velue .f eatate Subject t. TllX
If .n ........nt w.. i"u.d pr.viou.ly, 1in.. 14. 15 and,or 16, 17 .nd 11 will
refl.ct figur.. th.t includ. the tot.l of ALL r.turn. .......d to dat..
ASSESSMENT OF TAXI
15, _t of Line 14 et Spau..l rete (151
16, _t of Llne 14 tllXable .t L1_1/Cl... A rete n61
17. _t .f Line 14 tllXable et Coll.ter.l/Cle.. I rete (171
11, 'rlncloel T.. Due
TAX CREDITS I
PAYllENT
DATE
191
(101
4.235,00
1.949.55
1111
nZI
(151
(141
,00 X' 00.
,00 x, 06.
.00 X ,IS.
nil
AIIDUIfT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
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REIERVATlDfh E.t.t.. of "Men.. dvlne on .r b.f.,o ON.....r ." ...r ... If "I' lutu,. Intor..t In tM IItlt. .. tr....f.rred
1n po.....lon or "'Jo,..." t. CI... . CIOII.t.r.U benefl.l.rl.. of the _Iftnt Ift'r thl ..,lr.UOI'1 of In1 ..t,t.' for
llf. or f.r VII", the eo.en..Uh hlr.v ..,r...av reHrvoI thl rllhtto .."I.. Met IIIH" tr....f.r Inherltanc, TIICOI
It thlI '_hll ClI" I C"1I0,.,,1) ".t. on MW IUOh future.lnt.".t.
_lll'
NOTlCEa To fulfill the ,...I,-.nh of .....fN'I II.. of thl InhtrltMOl ... [.tlto TIIC Aot, Aat 21 of 1"5. (72 P.S.
holl.. tim,
PAVflENTI DetNfl "" '. ",tlOft of thAi .....a. end .uNit Mlth rour PI~lWlt to the R,,"tor of NUll prlnteel on the revor.. lido.
...... chIoIt or Mntw or.r ,.V..... ,,' RIaUrEI OF IIILU, AGENT
REfUND (CR)c . reklnd .f . till .redlt. Ilfhlcft .... not '"",.lld on thl TIll Retu,n. H_ be "quilted by. cOllphtlna ... -"'licit Ion
for .,fund of Ptnn.Vlvanll Inhlrlhnel 1M f.t.t. T.." (REV-ISIS). Aptllllc.Uon. er. ''''IUIbI. .t the OffiCI
of thl .....'er of WUII, .,y of thl n RIV8I'IUI Olltrlet Dfflc.., or bW c.UI", thl 'PlGI.1 24-hour
......rl'" "'wi.. nueDtre for fot'.. o'dorl",. In Penn.vlv"'l. 1-800-562-2050. ouhldll P","'yl........ 8nd
Mlthtn 1...1 He,rllburg er.. (7ln 7"-80", m. (717) 712"ZZ5Z (Hurl". I.-Ir. Only).
OIJECTIClHII Anv ,.,.tv In In'or..t not ..tllfl.....Uh the "'''''Merlt. OUOWMCO or db,UoMenc. of deduction.. or ...H.lMnt
of h. (lMholdl", dl'OOURt or Inter..t) I' ""*" an thl. NoUc. ..,.t obJDClt within .bcty (60) dlY' of rlC8l,t of.
thl. NIUe. bra
."wltt.. ,rotl" ,. tM 'A o."rt..,.' of .evonut, tN,iII of ap,qh, Dtp.t. lIIOZl, Hlrrllbur., Pi 17128-1021, 011
--.INtI", t. htYt the _Uer IIIt.r.lntil .t _It of the NGOW1t of tho PlrlClNll rlPr....t.tl...., 011
...,..1 t. the DrPh"I' Cour t.
AlliUM
IITIATlVE
CORRECTION'" 'MMI or,.n IIllCover. on ttll. .....~t .....111 1M "'r...... in MrIU". tOJ PA Dtplrbont of RIVIrIUI,
."..., .f IMI"ldual ,...., AftN, ..... ,........., Itnl... l.kl:1t, Dlpt. Z""I, Harrllbur.. Pi 171Z1-0601
..... 0". ",-"". ...,... I of the booIlI" .'ndruGtJonl for lm.rltlftC. TIIC A.tum for. Relldont
00ctGtn,. CIIV.IIII) f.r 1ft ..,Itn1tlon .f edllnl.t,.tlyel, corrlG'lbl. .rror..
If .,y 'I. ... II Hhl Mlthln u.,.. (I) ca'..r IIOnth, aft., thII IIIc:tcIont'. aath, . fl...o pore..t (5%) dlKCU'llt of
tM ,.. ",. It .U....
DllICOlIIT,
POW. ",
n. IU t.. ....tv ""'''",UII"".... "",117 It -.ut... on the 'otll of the tax and Inter..t, .....Md, Il'Id not
,,'111 IMf.,. .-.." '8, ."'. tho flnt _ .ft.,. the .... of thII te. ......tv ,..,locI. Thh non-p.rtlclpeUon
.....17 II WII1.la In the .... ....,. 1M In the the ... U.. perlocl .. YOU MOUld .....1 the tu end In..,..t
tN, hi. ..... .......... II ...llIt.. Oft thl. NUn.
lftt.....t 'I ...,.. ....IMI.. Mlth Urat .... .f dlU~r, or nlM I') -..nth. ... OM (1) III, froe tht dlw of
...u., t. the ..,. If ,.~t. '.... ....1_ e.c... ..Il.....-nt befor. ........., I, 1912 bier Iftt.,...t .t thII rat. of
,.. (.... """" per ..... 011U1.,.. .t . .U,-ret. .f ....."'. AU t.... Wtlch bee_ dllI~t on end .ft.,.
....." ., 'M' wU11l1111' In'.,..., .t . ret, ....IClh will vwv f,. coltndtr "or to c.lll'lIIttr POr ldttt thet rat.
......... ., .... " __....t ,f IOVWIUI. - Tho ..lleMll. Inttrllt retll for I,.Z thrOUlh It.. Dr"
INTPEIT I
uu In'....' "t. .lIv Inl....n helM' l'!!r 'ntlf'..t "to Dlllv In'trllt F.ctor
"" III ....141 1M' n .000247
1911 ua ."0411 ....~I"I lit .OOOSOI
I'" lit .IOUII I"! n .000247
1911 Ill< ....... ."'-1"'" n .0001'1:
I... In . It"" '"1.1- .a .101247
u'nt.,.... I, ..1_I.tM II f.U.."
JIl1DIIIT . IALAlICI or TAll U1lPAlD X IlVIIIEI or OAYI DELlJIlIUDlT X DAILY INTERElT FACTO.
..,.", "UM ..... .ft.,. IN ta. ....... ....,..., till. rtflKt ., Int",..t c,.cul.Uon to flU.. US) dh.
....... 1M .t. 'f .... .....INnt. If,....,l I. .... .ft.,. thII In'.,..., -.u'aUon dlta Ihc*n on the
......, "'111_. I",.,..t ...t ... eoIGUI,tlf.
oIV.15oo I!. 1709'1 :
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POI DATlS 0' DlATH "ml 12/31/91 CHICIC Hili
INHERITANCE TAX RETURN ~o~::~U::~DITIICLAIMID 0
RESIDENT DECEDENT PILI HUMIll
lTO BE FILED IN DUPLICATE 21
WITH REGISTER OF WILLS) COUNTY CODE
D D N' M l ,
+ +
20. 1/ Lin. 19 i. gro.'or "'.. Lin. 18, .n'or tho d;//.ronco on Lin. 20. T!W. i. tho OVER'AYMENT,
aD
21. 1/ Lin. 181. v,oo'or "'on Uno 19. .nto' Illo d;//or._ 011 L1n. 21. Ttw. i. tho TAX DUE,
A. En'or Illo We,... OIl Illo bola_ d.. OIl LIoo 21A.
I. En'or Illo to'ol 01 Uno 21 ond21" OIl LIoo 211. Thi. It Illo ....LAHCE DUE,
Mob Ch.cIr Poyobl. tol "II..., 01 Will.. A .t
1iii:..,1E TO ANSWEl ALL QUUnONS ON IEVElIE SIDE AND TO IECHECIC MATH --< --< .
Uftder ptftohi., of perjury. I d.dor. thO' I ho", ..omj",d thi, mUM, iftdudiflD OUOfftpoflyi"8 Kh.dlll.. and ,to,......",.. Dtld to thl b... of My kno~da. Oftd bt-1;.f,
ilia trll', con.d o"d compl.t.. I d,dore thot 011 ,",..tait ho. bee" report.cf crt trut morl.t \'Dlu.. D~clorotio" of prtpO,., othtt thOft t~ "!'JOnol '.p'HeMotive k
bo"d Oft ollln'oM\Otion Of which r, ,., hOI Oft bowled t.
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COMMONWeALTH 0' PENNSYLVANIA
DEPARTMENT 0' REVENUE
DfPT. 210601
HARIUSlURG, ,... 1712..0601
f EN' NAM (LA . I . AN Ml DLIINI IA4
Ji son Nanc L.
K>C:IAl 'ICUlun 1.:JMIIR
DA IOfll11 H
i1-19-66
94
YEAR
0159
HUMIER
2 East Main Street,
Newville, PA 17241
Apt. 3
DATl Of DEATH
173-54-1437
8-21-92
l" AmItAlUI Wtomwo ~I'I NAMt foAl'. f." ~ MIDDU "'''WI
AMOUNT I(CIIVED ISII IH$ llUClIONSJ
~i
I!lz
..Ii!
/Xl I. OrI;in.1 Rllvm 0 2. S.ppl....n'.1 R.lvr.
o A. Umk.d E...,. 0 A.. Fvlvro Intoro.. Compr.ml..
(lor d.'1l of deOlh .hor 12. I 2.82)
o 6. Otctdtnt Oitd Tt.talt 0 7. Dtctdtnl Maint,.!...d a Uvlng TruJ'
("'".ch copy 01 Will) ("'"och copy .f T..,,)
ALL COR,.:SPONDENCE AND CONFIDENTIAL TAX INFOlMAnON SHOULD 8E DIRECTED TOI
NM" John Ji pson c/o Mi chael J. Navitsky, E &~"%m~N'ito"~l!~' Front Street
"LEPHON' NU""" Harri sburg, PA ,17110
o 3. R.molnd" Retvm
(I.r d.," 01 d..,h p~o, 1.12.13,'2)
o 5. F.d".1 E.'.t. T., R.tvm R.qvlrod
_ 8. To'o' Numbe, 0' So" aopo." .....
z
3
g
Iii
1. R..I E.,.,. (Sch.dvl. "') (II
2. Stode. ond Bond. (Schtdulo B) 12 I
3. Oo..ly H.ld StdelPo"".""lp In'.".. (Schtdvl. 9 (3)
A. Mort;.SIl ond No'" R_l.obl. (Schtdvl. D) (AI h, Hj4.~~
5. COlh, Bon~ DtpolltJ & MiletllontouI 'tflOna! Property (5 )
(Sch.dvl. E)
6. J.ln,ly Own.d Pr.perty (Schtdul. 'I (6)
7. Trontlor. (Sch.dul. GI(Schtdvl. L) (7)
8. T.'ol G,... ......" ('.'.1 Un.. 1.7) 4,235,00
9. Funtral Exenl.., AdmlnlJtratlv. COlli, MilctllQI'I*aul (91
bp.n... ( ch.dvl. H) 1,949,55
10. D.b'., M.rt;.gl LiobUi'IIl, LIono (Sch.dul. I) (10)
II. T...I D.duction. ('.'.1 LinOl 9 & 10)
12. Not V.lv. of E...,. (Uno 8 minv. Uno 1'1
13. Cho~t.bl. ond Govem...n'.l 8oqvOl" {Sch.dvl. JI
IA. Not V.lvo Svbi'ct .. To. (Line 12 mln.. Uno 13
IS. Spov..l T,on.lo" (lor do'OI 01 de"'" oft.. 6-30-9')
kt'lnltructlons 'or ~Iicablt '.r(lntogt on Rtven. lIS)
Sid.. (Indvd. ..luOl m Sch.dvl. K 0' Sch.dulo M.I
16. Amount of lint ,. taxablt at 6~ ratt 116/
(Indud. volvOl from Sch.dul. K or Sch.dvl. M.I
1i. Amount of Line ~4 tox=:~lt O! 15% :'~. \17)
(Indvd. v.lvOl from Schtdvl. K 0' Sch.dvl. M.)
18. P~ndp.1 to. dv. (...dd..1 from Uno. IS, 16 ond 17.)
19, tr.dl" SpOll..1 'ovorty Crodll Prior PO)'fMnb DiKOunt 'nt.re,1
111)
(81 '6,184.55
6,184.55
-0-
(111
(121
(13)
114
-0-
x.__
x.06 .
x .15 . _
I
r
s
g
Ch("(:1t I-tru' ,f you OIl! rrquelllng 0 rrlund of your oYrrpovmt"nt
1191
(201
(21)
(21")
(21BI
.
,
Act '48, of 1994 provide. far the reduction of the lax rate.lmpo.ed on the nel value of Iransfer. to or far
the u.e of the 'flou.e. The rate. a. pre,crlbed by the .tolule will bel
.,
I 3% (.03) will be appllcoble far 1.lale, of decedlnt. dying an or after 7/1/94 and befelll 1/1/96
I 2% (.02) will be applicable for 1.lale. of decedenll dying an or after 1/1/96 and befall 1/1/97
I 1 % (.01) will be applicable for ellat.. of decedent. dying an or after 1/1/97 and befoll 1/1/98 '
t
I Spou,al transfer, occurring on or after 111/98 will be Ixempt from Inherllanee tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (...) IN THE APPROPRIATE BLOCKS.
Y 5 NO
1. Did decedent make a transfer and:
a. retain the u.e or income of the property transferred, ...................,..........,..................,.....
b. retain the right 10 designate who shall use th. property Iransferred or its Income, ...............
x
c. retain a rev.rsionary int.,..t; or ...................................................................................
x
X
X
.,.
X
X.
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
~1I~1I r.. v.-
" .,!f~
~1.1l'Io 01 NNNIY~rA
IN~I'IT'Na WllffUlH
IUIIlEN! OECE~NT
SCHEDUU H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLAN,EOUS EXPENSES
PI.a.. Print Dr l' .
Nancy L. Ji pson
21-94-0159
'" IRM
. 'HUMin
mCltlPTION
AMOUNT
A.
I.
PU_ILp..._1
Ewi n9 Brothers Funera I Home
630 South Hanover Street
Carlisle. PA 17013
(see attached bill)
$ 4,235,00
,I.
1.
Admllllatratlw COml
fIol1Oftol IWprtlttllotl.. Commlnlons
Sodol Socurlly Number 01 Pwsonal Raprtltllllall..,
Ytor Commlulona poid
2. AI1omoy F..
3. Family bomp~on
C1oilllOnI R.latlon'~lp
Add..... of Claimon! of d...dent'. dooth
Streot Add.....
City
A, Probot. F..
C. Mlacel'o_ bp._.
1.
2,
3.
A.
$.
6.
7.
I.
Slota ZIp r...t..
TOTAL (Abo _ 011 a.. 9.lltcopltvlollllrll $ 4.235;00
(If "'.... spaco II RtHM, hi.... olldltlonol ahom of _. 1Iz..)
. ..
,
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Nancy L. Jipson
Date of Death: 8/21/92
Will No,
Admin. No.21-1994-0159
pursuant to Rule
Court Rules, I report the
the administration of the
6.12 of the Supreme Court Orphans'
following with respect to completion of
above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2, If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a, Did the personal representative file a final
account with the Court? Yes No ,
Administrator filed a final inheritance tax return
b, The separate Orphans' Court No. (if any) for
the personal representative's account is:
c, Did the personal representative state an
account informally to the parties in interest? Yes
Date:
{ll/8/!l1l-::
d. copies of receipts, releases, joinders
approvals of formal or informal accou ts may be fi d wi
Cerk of the Orphans' Court and may batt he t is
c..J
0,
I
J. Navitsky
type or print
4503 N. Front Street, Hb .,PA
Address 17110
t717 1238-6791
Tel. No.
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1'1') .~ >_
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Capacity:
Personal Representative
counsel for personal
representative
1
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(HAH I rmfl AM3)
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JRD/June 30, 1992117858
'~
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REGISTER OF WILLS
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
,
'I
(.f
Distribution to Estate File
NOTICE PURSUANT TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To: Personal Representative
,Counsel: MICHAEL NAVUbll.X, r,bl,J.,
RE: E5tate of NANCY L. JIPSCtl , Deceased, Late of
NE.WVILLE OOIOJGH
E5tate No.: 21-1994.0159
Date of Decedent's Death: R.?l.l qqJ
Pursuant to Rule 6.12. the above named personal representative or the above named attorney, if
applicable, within two (2) years of the decedent's death, and annually thereafter until administration is
completed, is required to file with the Register of Wills a Status Report as required by Rule 6,12, in
substantially the prescribed form, showing the date by which the personal representative, or attorney, as
applicable, reasonably believes administration will be completed, The purpose of this Notice is to advise
you that unless the requisite Status Repon is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the RegisterofWlIIs
is required to notify the Orphans' Court Division, Court of Common Pleas of such delinquency and to
request that said CoUIt conduct a hearing to determine whether sanctions should be imposed upon the
delinquent personal representative and the delinquent persOnal representative's counsel. if any,
Accordingly, if the requisite Status Report is not filed by IO.l?gR , 19_, you are hereby
advised that a request will be submitted to the Court in accordance with Rule 6.12,
Date: q.?R.9R ~rJ.~~//.m/)"'nA4r<;-
Deputy J{egister of Wills .. , r~'
-.